Acetabular cup assembly for multiple bearing materials

ABSTRACT

A modular acetabular cup assembly for use with multiple bearing liners is disclosed. The acetabular cup assembly includes a shell having a tapered inner wall and two circumferential grooves. The shell may be used with polyethylene, ceramic, metal, and other types of liners.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a divisional of pending U.S. application Ser. No.15/288,568, filed Oct. 7, 2016, which application is a continuation ofU.S. application Ser. No. 14/171,828, filed Feb. 4, 2014 and now issuedas U.S. Pat. No. 9,463,094, which is a continuation of U.S. applicationSer. No. 12/293,705, filed Sep. 29, 2010 and now issued as U.S. Pat. No.8,679,187, which is a U.S. National Phase filing of InternationalApplication No. PCT/US2006/060044, filed Oct. 18, 2006, which claims thebenefit of U.S. Provisional Application No. 60/783,937, filed Mar. 20,2006. The disclosure of each of these applications is herebyincorporated by reference in its entirety.

BACKGROUND OF THE INVENTION Field of the Invention

The present invention relates to acetabular cups and, more particularly,to acetabular cup assemblies for use with multiple bearings.

Related Art

In hip arthroplasty, various bearing materials are available for theacetabular cup portion of an implant. The selection of the bearingmaterial is typically determined by the surgeon prior to performance ofthe procedure. At times, however, final selection of the bearingmaterial is not completed until the implant site is prepared andconditions at the site are evaluated. Thus, it is sometimes advantageousto utilize an acetabular shell that accepts multiple bearing liners sothat the surgeon can revise the initial assessment if required.

Acetabular shells that accept multiple bearings have been used in Europesince the early 1980s. Typically, the outer shell featured a taperedinside geometry in which a tapered hard or soft bearing could beinserted. In these cases, soft bearing thickness, lock integrity andwear performance were compromised in an effort to accommodate bothbearings.

More recently, Stryker Corp. of Kalamazoo, Mich., U.S.A., has developedan acetabular cup that accepts a fully metal-encapsulated ceramicinsert, which is held via a taper lock connection. The shell alsoaccepts a polyethylene insert that is locked via one circumferentialbead located mid-point along the inner taper and is rotationallystabilized by four conforming features between the shell and the liner.

An acetabular cup assembly for use with multiple bearings is desirablefrom a manufacturing standpoint because it is only necessary to produceone shell for use in many applications. This increases the volume ofshells produced, which decreases overall production costs. Further,production of a single shell reduces distribution costs.

An acetabular cup assembly for use with multiple bearings is desirablefrom a revision standpoint because it gives the surgeon greaterflexibility and reduces the overall time of the operation. First, theassembly gives the surgeon greater flexibility because the surgeon caneasily make adjustments to the hip prosthesis. For example, if theoriginal prosthesis had a polyethylene liner, the surgeon can easilysubstitute a ceramic or metal liner without changing the shell. Second,the assembly reduces the overall operation time because it is notnecessary to remove the shell. Typically, the installed shell issurrounded by ingrown bone, which is very difficult and time consumingto remove. Further, removal of the installed shell may result insignificant bone loss. By eliminating the step of removing the shell,the surgeon can complete the revision in less time with less effort andthe result is less traumatic to the patient.

Micromotion between a polyethylene liner and an acetabular shell isundesirable as the motion creates polyethylene debris, which eventuallycauses bone osteolysis. Prior polyethylene bearing lock mechanism weredesigned to exhibit minimal micromotion between the liner and the shell.However, these mechanisms also required an excessive interoperativeinsertion force for insertion of the liner. A high insertion force isundesirable as it requires greater effort on behalf of the surgeon toinstall the liner.

Traditionally, ceramic liner manufacturers have advised againstreinsertion of ceramic liners due to the stress sensitive nature of thematerial. The material may fracture at break if stressedinappropriately. However, for various reasons, it may be desirable toremove and reinstall a liner. As an example, a surgeon may want toremove the ceramic liner during installation change the shell position,and reinstall the liner. As ceramic manufactures presently adviseagainst this, a surgeon takes on great risk when making these types ofadjustments during ceramic liner installation.

There remains a need in the art for an acetabular cup assembly for usewith multiple bearings.

SUMMARY OF THE INVENTION

The invention is briefly, an acetabular cup assembly. The assemblyincludes a shell and a liner. The shell has an inner surface and anouter surface. The inner surface has a first groove, a second groove,and a tapered inner wall. The liner is adapted to fit within the innersurface of the shell. The liner is selected from the group consisting ofa polymer liner, a ceramic liner, and a metal liner, and the polymerliner has an inner portion and an outer portion, the outer portionincludes a first bump and a second bump, the ceramic liner includes aband, and the metal liner includes a tapered outer portion.

In one embodiment of the invention, the polymer liner is selected fromthe group consisting of cross-linked polyethylene and conventionalpolyethylene.

In another embodiment of the invention, the liner includes anti-rotationtabs and the shell includes at least one scallop. The scallops aredimensioned to receive the anti-rotation tabs.

In yet another embodiment of the invention, the shell includes aninsertion tool hole.

The insertion tool hole may be used in conjunction with a tool toinstall the shell.

In still another embodiment of the invention, the inner surface of theshell is highly polished. The inner surface may have a surface roughnessof about one to about sixteen microinches, and rather about one to abouteight microinches. The highly polished surface reduces polymer linerdebris if micromotion happens to occur between the shell and the liner.

In another embodiment of the invention, the shell is made from amaterial selected from the group consisting of titanium, cobaltchromium, and stainless steel.

In yet another embodiment of the invention, the shell further comprisesat least one fixation hole. The fixation hole is adapted to receive oneor more fixation devices to attach the shell to bone.

In still another embodiment of the invention, the shell furthercomprises a porous coaling on the outer surface. The porous toutingallows for bone in growth.

In another embodiment of the invention, the band has a taper. The bandmay be tapered from about two degrees to about thirty-six degrees, andrather the band has a taper of about eighteen degrees.

In yet another embodiment of the invention, the tapered inner wall, theband or the tapered outer portion includes a surface enhancement. Thesurface enhancement may be selected from the group consisting of anacme-type stair-step, a reverse stair-step, or a predetermined surfaceroughness. The surface enhancement augments the locking of the liner.

In still another embodiment of the invention, the acetabular cupassembly may have a constrained bearing liner. The liner may utilize alocking feature, such is a metal locking ring or an annular flange.

The acetabular cup assembly may have a two-piece liner that includes abearing surface component and a capture mechanism. The capture mechanismis locked into the shell after hip reduction.

In another embodiment of the invention, the liner is selected from thegroup consisting of a constrained liner, a neutral liner, an antevertedliner, a lipped bearing liner, and a lateralized bearing liner.

In yet another embodiment of the invention, the acetabular cup assemblyfurther comprising an installation tool attached to the liner. Theinstallation tool is comprised of metal or plastic.

In one particular embodiment of the invention, the invention is amodular acetabular cup assembly for use with multiple bearing liners.The acetabular cup assembly includes a shell having an inner wall, twoannular grooves, and a plurality of anti-rotation tabs. The shell may beused with polyethylene, ceramic, metal, and other types of liners. Inthe case of a ceramic liner, a band is attached to the liner. The bandis adapted to mate with the inner wall. The band on the ceramic linerenables the shell to be used with an off-the-shelf liner without theneed for more expensive, custom made liners.

In yet another embodiment of the invention, the shell has a generallyconcave inner surface, an outer surface, an end face formed at anuppermost end of the shell and an apex formed at a lower end of theshell, a central axis extends through the apex, wherein the innersurface comprises an inwardly-facing scallop defined in the innersurface and extending into the end face. A line extends from where theinner surface meets the lower groove to where the central axis meets aplanar surface defined by a plane extending through the face of theshell, the central axis and the line defining an angle, and wherein theangle ranges from about ten degrees to about eighty degrees. In otherembodiments, the angle ranges from about forty to about seventy degrees.

In another embodiment of the invention, the first groove and the secondgroove are separated by a first distance, and the first distance rangesfrom about one millimeter to about twenty millimeters. In otherembodiments, the first distance ranges from about two millimeters toabout four millimeters.

In yet another embodiment of the invention, the band has an innersurface and an outer surface spaced apart from the inner surface by asecond distance, and the second distance varies from about one-halfmillimeter to about 30 millimeters. In other embodiments, the distanceranges from about one-half millimeter to about ten millimeters.

The invention offers the advantage of two annular grooves or cavitiesthat receive annular bumps or ribs of the liner. The grooves may or maynot fully extend about an interior of the shell. The use of two ribs andgrooves is significant as the effective push-in and push-out of theliner can be controlled and optimized by adjusting the tolerances anddimensions of these four items and the interference between the shelland the liner. Thus, the acetabular cup assembly may be designed suchthat a surgeon may easily be able to push in the liner by hand but theliner will not disassemble front the shell without the use of a tool.

The band also allows the ceramic liner to be reinserted should thisbecome necessary interoperatively. Furthermore, the band improves theforce distribution around the liner and significantly reduces thepotential for liner fracture, particularly in the event of amisalignment.

Further areas of applicability of the present invention will becomeapparent from the detailed description provided hereinafter. It shouldbe understood that the detailed description and specific examples, whileindicating the preferred embodiment of the invention, are intended forpurposes of illustration only and are not intended to limit the scope ofthe invention.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will become more fully understood from thedetailed description and the accompanying drawings, wherein:

FIG. 1 is a sectional side view of an acetabular cup assembly in a firstembodiment;

FIG. 2 is a front perspective view of the acetabular cup assembly shownin FIG. 1;

FIG. 3 is a front perspective view of a shell;

FIG. 4A is a partial sectional side view of the acetabular cup assembly;

FIG. 4B is a sectional view of an exemplary shell having intermittentlyspaced grooves;

FIG. 4C is a partial sectional view of an exemplary shell having bumpsthat are separate components coupled to an outer body of the shell andengaged with an adjacent groove;

FIG. 5 is a sectional side view of the shell;

FIG. 6 is a sectional side view of an acetabular cup assembly in asecond embodiment;

FIG. 7 is a partial from perspective view of Ute acetabular cup assemblyshown in FIG. 6;

FIG. 8 is a sectional side view of an acetabular cup assembly in a thirdembodiment;

FIG. 9 is a partial front perspective view of the acetabular cupassembly shown in

FIG. 8;

FIG. 10 is a first embodiment of a surface enhancement;

FIG. 11 is a second embodiment of a surface enhancement;

FIG. 12 is a third embodiment of a surface enhancement;

FIG. 13 is an exploded side view of an acetabular cup assembly in afourth embodiment;

FIG. 14 is an exploded side view of in acetabular cup assembly in afifth embodiment;

FIG. 15 is an exploded front perspective view of a modular acetabulartrialing system;

FIG. 16 is a front perspective view of the modular acetabular trialingsystem shown in

FIG. 15;

FIG. 17 is a sectional side view of an installation tool in a firstembodiment in use on a liner;

FIG. 18 is a front perspective exploded sectional view of the shell, theinstallation tool applied to the liner, and an impactor head;

FIG. 19 is a front perspective view of the shell, installation tool, andliner;

FIG. 20 is a sectional side view of the shell, the installation toolapplied to the liner, and the impactor head;

FIG. 21 is a top view of the installation tool in a second embodiment;

FIG. 22 is a sectional front view of the embodiment shown in FIG. 21;

FIG. 23 is a sectional front view of a fixture for mounting a band to aliner in a first embodiment; and

FIG. 24 is a sectional front view of a fixture for mounting a band to aliner in a second embodiment.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The following description of the preferred embodiment(s) is merelyexemplary in nature and is in no way intended to limit the invention,its application, or uses.

FIGS. 1 and 2 illustrate, an acetabular cup assembly 10. The acetabularcop assembly 10 includes a shell 12. The shell 12 is adapted ferule withmultiple bearing linen, such us a first liner 32. The first liner 32 maybe any number of liners but is a polymer liner in the embodimentdepicted in FIGS. 1 and 2. For example, the first liner 32 may be across-linked polyethylene liner or a conventional polyethylene liner.The first liner 32 includes anti-rotation tabs 33. The shell 12 includesan insertion tool hole 38, which is used to receive a tool (not shown)for installation of the shell. In the depicted embodiment, the insertiontool hole 38 is threaded.

As best seen in FIG. 3, the shell 12 includes un inner surface 14. Inthe embodiment illustrated in FIG. 3, the inner surface 14 has a concaveshape but other shapes may be used. In some embodiments, the innersurface 14 is highly polished such that it appears mirror-like. Forexample, the inner surface may have a roughness from about one microinchto about sixteen microinches. In the depicted embodiment, the innersurface has a roughness from about eight microinches to about sixteenmicroinches. In some embodiments, the inner surface has a roughness ofabout 1 microinch to about eight microinches. A highly polished innersurface 14 significantly reduces or prevents polymer liner debrisgeneration.

In the embodiment depicted in FIG. 3, the shell 12 is made of metal butthose skilled in the art would understand that other materials couldequally be used. As examples, the shell 12 may be made of titanium,cobalt chromium, stainless steel, or other biocompatible material.

The shell 12 includes a face 54 and scallops 16 which receiveanti-rotation tabs 33. In the embodiment depicted in FIG. 3, the shell12 includes twelve scallops 16 and the first liner 33 has twelvecorresponding anti-rotation tabs 33 to achieve greater microstability.Each scallop 16 forms a lip or lodge 18 on an inner wall 28 of the shell12. The shell 12 further includes an annular groove 20 that extendsperipherally or circumferentially about the inner wall 28. The shell 12also includes a notch 22. The notch 22 allows a pry tool access to theliner portion of the assembly.

In some embodiments, the shell 12 may include one or more fixation holes40. A screw, modular peg, or other fixation device (not shown) may beinserted through the fixation hole 40 to attach the shell 12 to bone.Further, in some embodiments the shell may have a porous coating on itsexterior. As examples, the exterior of the shell 12 may have a sinteredmetal coating, a vapor deposited metal coating, a thermal spray metalcoaling, or be chemically etched. The porous coating may allow for bonein-growth into the shell 12.

The shell 12 includes a first groove 24 and a second groove 26.Alternatively, the grooves 24, 26 may be termed indentations orcavities. The grooves 24, 26 may or may not fully extend about aninterior 30 of the shell 12. Thus, as seen in FIG. 4B, the groove 24, 26may form annular rings, have a “C” shape, be intermittently spaced aboutthe circumference, have a hemispherical shape, or have some other shape.As best seen in FIG. 4, the first groove 24 and the second groove 26respectively receive a first bump 34 and it second bump 36 of the firstliner 32. The first bump 34 alternatively may be referred to as a firstinsertion member or first rib and the second hump 36 alternatively maybe referred to as a second insertion member or second rib. As seen inFIG. 4C, in the case of a metal or ceramic liner, the bumps 34, 36 maybe a separate component, such as a split ring or spring, or molded tothe exterior, or outer body 35, of the liner.

The use of two protrusions and grooves is significant as the effectivepush-in and push-out of the liner 32 can be controlled by adjusting thetolerances and dimensions of these four items. For example, it ispossible to have the liner 32 installed with a small push-in force butalso have a significant push-out force. Thus, a surgeon may easily beable to push-in the liner by hand but the liner will not disassemblefrom the shell without the use of a tool. In another example, the liner32 may be installed with a high push-in force and have an even greaterpush-out force. A protrusion 25 is formed in between the grooves 24, 26,and can inwardly extend from an adjacent inner portion of a segment ofthe inner surface 14. By controlling the interference between sheprotrusion 25 and the second bump 36 and the other dimensions, one canadjust the push-in and push-out force. If the second bump 36 greatlyinterferes with the protrusion 25, then the liner 32 will have both ahigh push-in and push-out. In this case, it may be necessary tosignificantly cool the liner 32 prior to installation to temporarilyreduce its size. However, if the second bump 36 only slightly interfereswith the protrusion 25, then the liner 32 may be inserted utilizing alow push-in force and removed utilizing a high push-out force. This isbecause once the bumps 34, 36 engage the grooves 24, 26, both bumps willcontribute to the push out force required. However, in the case ofpush-in, the force required is only enough for the second bump 36 toclear the protrusion 25 and for the first bump 34 to engage the firstgroove 24.

The first groove 24 and the second groove 26 are located below the innerwall 28. This is significant because the location of the grooves 24,26shelters the locking mechanism of the first liner 32 from soft tissueinterference. In other words, because the bumps 34, 36 engage thegrooves 24, 26 on a lower portion of the shell 12, the likelihood ofsoft tissue interference with the locking of the first liner 32 to theshell is significantly reduced.

FIG. 5 illustrates a view of the shell 12. The shell 12 has a centralaxis 50 that extends through the apex of the shell. The grooves 24, 26are located on the inner surface 14 of the shell 12. A line L extendsfrom where the inner surface 14 meets the lower groove 26 to where thecentral axis 50 meets a planar surface 52. The planar surface 52 isdefined by a plane extending through the face 54 of the shell 12. Anangle A is defined by the central axis and the line L. The angle A isabout 10 degrees to about 80 degrees. In the embodiment depicted in FIG.5, the angle A is about −40 degrees to about 70 degrees. FIG. 5 alsoillustrates a first distance or dimension D1. The dimension D1 is thedistance between the upper groove 24 and the lower groove 26. Thedimension D1 is about 1 to about 20 millimeters. In the embodimentdepicted in FIG. 5, the dimension D1 is about 2 to about 4 millimeters.

FIGS. 6 and 7 illustrate a second embodiment of the acetabular cupassembly generally indicated by reference numeral 100. The acetabularcup assembly 100 includes a second liner 110, a band or ring 112, andthe shell 12. As an example, the second liner 110 may be a ceramicliner, such as an alumina ceramic liner. Further examples include adiamond liner, a liner made of a polycrystalline diamond compositematerial, a liner made from oxidized zirconium, or a liner made frompolyethylene, including cross linked polyethylene. The band 112 may bemade of metal. For example, the band 112 may be made of stainless steel,titanium, cobalt chromium, or a shape memory alloy, such as nitinol. Theband 112 is affixed to an outer portion 114 of the liner 110. The band112 is adapted to mate with the inner wall 28 of the shell 12. The band112 and the inner wall 28 may be tapered. For example, the inner wall 28may be tapered from about two degrees to about thirty-six degrees. Inthe embodiment depicted in FIG. 6, the inner wall 28 has about aneighteen degree taper. The band 112 allows a ceramic liner to be removedand reinserted. This is significant, as previously removal andreinstallation of a ceramic liner was inadvisable. Further, the band 112improves the force distribution around the second liner 110 andeliminates, or at least significantly reduces, the potential forcracking of a ceramic liner upon insertion, especially if there is anymisalignment. The liner 110 has a face 130. The band 112 may extendabove the face 130, below the face 130, or substantially flush with theface 130. If the band 112 extends above the face 130, the band 112 mayprevent impingement in some circumstances. In the embodiment depicted inFIGS. 6 and 7, the band is substantially flush with the lace 130.

The band 112 has an inner surface 140 and an outer surface 142 spacedapart from the inner surface 140. The inner surface 140 is sized andshaped to compliment the outer portion 114 of the liner 110, and theouter surface 142 is sized and shaped to compliment the inner wall 28.The outer surface 142 is spaced apart from the inner surface 140 by asecond distance or second dimension D2. The distance D2 may vary fromabout one-half millimeter to about 30 millimeters, and rather from aboutone-half millimeter to about ten millimeters. In the embodiment depictedin FIG. 6, the distance D2 is about three-fourths of a millimeter.

In some embodiments, the shell 12 way accept differently sized liners.The acetabular cup assembly 100 may include a plurality of liners, eachhaving a band with a differently sized inner surface but each having thesame size outer surface. Thus, the plurality of liners all fit the sameshell because the outer surface is the same size. However, the innersurface is differently sized allowing for differently sized liners, thedifference in size is adjusted by adjusting the distance D2 of the band112. As an example only, the single shell 12 may accept 26, 28, and 32millimeter inner diameter liners. This is significant as the modularityreduces manufacturing costs and provides surgeons with a greater numberof interoperative choices.

In outer embodiments, the liner 110 may fit within differently sizedshells. The acetabular cup assembly 100 may include a plurality ofliners, each having a band with a differently sized outer surface huteach having the same size inner surface. Thus, the plurality of linerseach have the same inner diameter size but has differently sized outersurface that compliments a particular size of shell. The difference insize is adjusted by adjusting the distance D2 of the band 112. As anexample only, the single liner 110 may fit within 46, 48, and 50millimeter inner diameter shells. This is significant as the modularitywithin manufacturing costs and provides surgeons with a greater numberof intraoperative choices.

FIGS. 8 and 9 illustrate a third embodiment of the acetabular cupassembly, generally indicated by reference numeral 200. The acetabularcup assembly 200 includes a third liner 212 and the shell 12. As anexample, the third liner 212 may be a metal liner, such as cobaltchromium. Alternatively, the third liner 212 may be a ceramic, plastic,or composite. The liner 212 includes an outer portion 216. The outerportion 216 is adapted to mate with the inner wall 28 of the shell 12.The outer portion 216 and the inner wall 28 may be tapered. For example,the inner wall 28 may be tapered from about two degrees to aboutthirty-six degrees. In the embodiment depicted in FIG. 8, The inner wall28 has about an eighteen degree taper. In some embodiments, the assembly200 may further include plug 214. The plug 214 may be used to coverfixation devices or used to fill unused holes. In FIG. 9, the plug 214has been removed for clarity.

FIGS. 10, 11, and 12 illustrate various surface enhancements that may beapplied to the band 112 or the outer portion 214 for lock enhancement ofthe liner. In FIG. 10, an Acme-type “stair-step” 220 may be machinedinto the band 112 or the outer portion 216. Similarly, in FIG. 11 a“reverse stair-step” 222 may be machined into the band 112 or the outerportion 216. The stair-step surface configuration 220 or are reversestair-step configuration may be lined to maintain lock integrity evenafter multiple reinsertions. In FIG. 12, the band 112 or the outerportion 216 may have predetermined surface roughness 224. The surfaceroughness 224 may be achieved by coarse media blasting, such as by gritblast, glass bead blast etc. Alternatively, the surface enhancements220, 222, 224 could be applied to the inner wall 28. Moreover, numeroustypes of coatings may be applied to the band 112, the outer portion 214,or the inner wall 28. As examples, these surfaces may have a metal,plastic, diamond, or composite coating.

FIG. 13 illustrates a fourth embodiment of the acetabular cup assembly,generally indicated by reference numeral 300. The acetabular cupassembly 300 includes the shell 12 and a constrained bearing liner 310.In a constrained bearing liner, a femoral head 312 is captured withinthe liner. Constrained bearing liners often utilize a third lockingfeature as they typically require a higher disassociation force. In FIG.13, a metal locking ring 314 interfaces with the first groove 24.Alternatively, an annular flange may be attached to the liner and theannular flange engages the first groove 24. The locking ring 314 may beused with either a one-piece or two-piece constrained liner construct.

FIG. 14 illustrates a fourth embodiment of the acetabular cup assembly,generally indicated by reference numeral 350. The acetabular cupassembly is a two-piece construct that includes the shell 12, a bearingsurface component 354, and a capture mechanism 358. For the two-piececonstruct, the bearing surface component 354 is inserted into the shell,the femoral head 356 is placed in the liner, and the capture mechanism358 is placed over the femoral component 356 prior to head assembly.Once the hip is reduced, the capture mechanism 358 is inserted andlocked into the shell thereby securing the full assembly construct. Asan example, the capture mechanism may engage the annular groove 20 (bestteen in FIG. 3).

The liners 32, 110, 212, 310, 354 may be neutral liners, anteveretdbearing liners, lipped bearing liners, or lateralized bearing liners.Thus, the depicted embodiments are merely exemplary. Further, aninterior or an exterior of the linen 32, 110, 212, 310, 354 may becoated with various types of coatings. For example, these surfaces mayhave a metal, plastic, diamond, or composite coating.

FIGS. 15 and 16 illustrate a modular acetabular trialing system 400. Theacetabular trialing system 400 includes a trial liner 410, a trialspacer 412, and a trial shell 414. Modularity greatly reduces the numberof trialing components necessary to cover the full range of sizesoffered in the acetabular cup system, which further simplifies theamount of instrumentation required for surgery. The trial liner 410 andthe trial spacer 412 may be used with the trial shell 414 or theimplantable shell 12.

FIGS. 17, 18, 19 and 20 illustrate a method and apparatus for installingthe liner 32, 110, 212, 310, 354. A first embodiment of an installationtool 500 is attached to the liner 32, 110, 212, 310, 354. Theinstallation tool 500 is substantially circular. In some embodiments,the installation tool 500 has a cutout 502. The installation tool 500has a first shoulder 504 and a second shoulder 506. Alternatively, thesefeatures may be termed as a first capture, recess 504 and a secondcapture recess 506. In some embodiments, the first shoulder is identicalto the second shoulder such that either side of the installation toolmay be used. In outer embodiments, the first shoulder 504 is larger orsmaller than the second shoulder 506 such that the installation tool 500may accommodate various sizes of liners 32, 110, 212, 310, 354. Thefirst shoulder 504 and the second shoulder 506 may be square or tapered.In the tapered embodiments, the first and second shoulders 504, 506 maytaper outwardly for manufacturing purposes or taper inwardly to provideline contact with the liner.

In the method, the installation tool 500 is slightly spread open andattached to the liner 32, 110, 212, 310, 354 until either the firstshoulder 504 or the second shoulder 506 contact the liner. Theinstallation tool 500 is resilient and biased to spring back into itsoriginal position. Thus, the installation tool 500 is attached to theliner 32, 110, 212, 310, 354 through the use of a spring force.

Once the installation tool 500 is assembled to the liner 32, 110, 212,310, 354, the installation tool 500 and the liner 32, 110, 212, 310, 354are placed over the shell 12. Thereafter, an impactor head 510 may beused to press on the liner 32, 110, 212, 310, 354 to remove the linerfrom the installation tool 500 and install the liner in the shell 12.The use of the installation tool 500 allows for automatic centering andalignment of the liner 32, 110, 212, 310, 354 within the shell 12. Theuse of the installation tool 500 significantly reduces the possibilitythat the liner may become askew relative to the shell upon installation.Further, the installation tool 500 may serve as a soft tissue retractorduring installation. The outer portion of the installation tool 500 maybe used to push soft tissue aside as the liner is inserted into theshell.

The installation tool 500 may be re-usable or disposable. For example,the installation tool 500 may be made of metal, such as stainless steel,and the installation tool may be sterilized and re-used afterinstallation of the liner. Alternatively, the installation tool 500 maybe made from a polymer or plastic and disposed of after liner insertion.In the case of a plastic material, the installation tool may be colorcoded to indicate a particular size or to indicate a particular brand.

FIGS. 21 and 22 illustrate a second embodiment of the installation tool,generally indicated by numeral reference 600. The installation tool 600includes a notch 610. The notch 610 allows an inner portion 620 of theinstallation tool 600 to flex. Thus, the bending of the inner portion620 provides a spring force that can be applied in the liner 32, 110,212, 310, 354. Similar to the first embodiment, the installation tool600 is assembled to the liner 32, 110, 212, 310, 354, the installationtool 600 and the liner are placed over the shell 12. Thereafter, animpactor head 510 may be used to press on the liner to remove the linerfrom the installation tool 600 and install the liner in the shell 12.The use of the installation tool 600 allows for automatic centering andalignment of the liner within the shell 12.

FIG. 23 illustrates a first embodiment of a fixture 700 for use ininstalling the band 112 on the liner 110. The fixture 700 includes afixture face 704 and a well 706. To install the band 112 on the liner110, the band 112 and the liner 110 are placed on the fixture 700 and apress (not shown) with a press platen 702 is used to press the band 112on the liner 110. First, the fixture 700 is mounted to the press, whichmay be a computer numerically controlled press. Second, the press is setwith a displacement rate, a minimum force, and a maximum force. Thedisplacement rate may be from about 0.01 inch per minute to about 2.00inches per minute maximum. In the depicted embodiment, the displacementrate is about 0.80 inches per minute to about 1.10 inches per minutemaximum. The minimum force ranges from about 5000 pounds to 11000pounds. In the depicted embodiment, the minimum force is about 8000pounds. The maximum force ranges from about 8000 pounds to about 15000pounds. In the depicted embodiment, the maximum force is about 10000pounds. Third, the band 112 is placed on the liner 110 by hand. Fourth,the band 112 and the liner 110 are placed on the fixture 700 with theliner 110 protruding into the well 706 and the hand 112 resting on thefixture face 704. Fifth, the press platen 702 is advanced until it makescontact with me face 130 of the liner 110. The initial preload force onthe liner 110 may be from about zero pounds to about ten pounds. Sixth,the press platen 702 applies a force F on the liner 110 until adisplacement D3 is achieved between the band 112 and the liner 110. Thedisplacement D3 is zero with a tolerance of one millimeter in eitherdirection. Optimally, the displacement D3 is zero with a tolerance ofabout one-quarter of a millimeter in either direction. Thereafter, theassembled hand 112 and the liner 110 are inspected for material transferblemishes. A microscope may be used to inspect the assembly.

FIG. 24 illustrates a second embodiment of a fixture 800 for use ininstalling the band 112 on the liner 110. The fixture 800 includes acounter bore 803, a fixture face 804 and a well 806. To install the band112 on the liner 110, the band 112 and the liner 110 are placed on thefixture 800 and a press (not shown) with a press platen 802 is used topress the band 112 on the liner 110. First, the fixture 800 is mountedto the press, which may be a computer numerically controlled press.Second, the press is set with a displacement rate, a minimum force, anda maximum force. The displacement rate may be from about 0.01 inch perminute to about 2.00 inches per minute maximum. In the depictedembodiment, the displacement rate is about 0.80 inches per minute toabout 1.10 inches per minute maximum. Thu minimum force ranges fromabout 5000 pounds to 11000 pounds. In the depicted embodiment, theminimum force is about 8000 pounds. The maximum force ranges from about8000 pounds to about 15000 pounds. In the depicted embodiment, themaximum force is about 10000 pounds. Third, the band 112 is placed onthe liner 110 by hand. Fourth, the band 112 and the liner 110 are placedon the fixture 800 with the liner 110 protruding into the well 806 andthe band 112 resting in the counter bore 803 and on the fixture face804. The counter bore 803 provide the advantage of self-centering theassembly over the well 806. Fifth, the preys platen 802 is advanceduntil it makes contact with the face 130 of the liner 110. The initialpreload force on the liner 110 may be from about zero pounds to aboutten pounds. Sixth, the press platen 802 applies a force F on the liner110 until a displacement D3 is achieved between the hand 112 mid theliner 110. The displacement D3 is zero with a tolerance of onemillimeter in either direction. Optimally, the displacement D3 is zerowith a tolerance of about one-quarter of a millimeter in eitherdirection. Thereafter, the assembled hand 112 and the liner 110 areinspected for material transfer blemishes. A microscope may be used toinspect the assembly.

In view of the foregoing, it will be seen that the several advantages ofthe invention are achieved and attained.

The embodiments were chosen and described in order to best explain theprinciples of the invention and its practical application to therebyenable others skilled in the art to best utilize the invention invarious embodiments and with various modifications as are suited to theparticular use contemplated.

As various modifications could be made in the constructions and methodsherein described and illustrated without departing from the scope of theinvention, it is intended that all matter contained in the foregoingdescription or shown in the accompanying drawings shall be interpretedas illustrative rather than limiting. For example, while the firstgroove and the second groove have been depicted as annular, those ofordinary skill in the art would understand that the grooves may beintermittently spaced about the inner surface of the shell and stillachieve the same function. Thus, the breadth and scope of the presentinvention should not be limited by any of the above-described exemplaryembodiments, but should be defined only in accordance with the followingclaims appended hereto and their equivalents.

The invention claimed is:
 1. An acetabular cup system, comprising: ashell having a generally concave inner surface, an outer surface, an endface formed at an uppermost end of the shell, an apex formed at a lowerend of the shell, and a central axis extending through the apex, whereinthe inner surface comprises an inwardly-facing scallop defined in theinner surface and extending into the end face, at least a portion of theinner surface defining a taper with respect to the central axis, thetapered portion of the inner surface extending below the scallop, aprotrusion located below the tapered portion of the inner surface, and alower groove located below the protrusion; a first liner comprisinggenerally convex first outer portion, the first outer portion includingan outwardly-extending tab and a lower bump, wherein the first liner isformed of a polymer material; and a second liner comprising a generallyconvex second outer portion, the second outer portion including atapered outer wall, wherein the second liner is formed of a metallicmaterial; wherein the shell is configured to receive each of the firstliner and the second liner; wherein when the first liner is seated inthe shell, the tab is received in the scallop, the lower bump isreceived in the lower groove and engaged with a lower side of theprotrusion, and an interference fit is formed between the first linerand the shell, the interference fit including at least engagement of thelower bump with the lower groove; and wherein when the second liner isseated in the shell, the tapered outer wall is engaged with the taperedportion of the inner surface upper wall of the shell, and the secondliner is retained in the shell by engagement between the tapered portionof the inner surface and the upper wall.
 2. The system of claim 1,further comprising a third liner including a generally convex thirdouter portion, the third outer portion including a second tapered outerwall; wherein the third liner is formed of a ceramic material; andwherein when the third liner is seated in the shell, the tapered portionof the inner surface is engaged with the second tapered outer wall, andthe third liner is retained in the shell by engagement of the taperedportion of the inner surface with the second tapered outer wall.
 3. Thesystem of claim 2, further comprising a tapered band; wherein when thethird liner is seated in the shell, the tapered band is positionedbetween the tapered portion of the inner surface and the second taperedouter wall such that the tapered portion of the inner surface is engagedwith the second tapered outer wall through the tapered band.
 4. Thesystem of claim 1, wherein a portion of the wall extending below thetapered portion defines an upper groove, and wherein the first linerfurther comprises an upper bump sized and shaped to be received in theupper groove.
 5. The system of claim 4, wherein a distance between theupper groove and the lower groove is between two millimeters and fourmillimeters.
 6. The system of claim 1, wherein the lower groove has acurved cross-section along a plane including the central axis.
 7. Thesystem of claim 4, wherein the protrusion is positioned between thelower and upper grooves.
 8. The system of claim 1, wherein the lowergroove is partially defined by the protrusion.
 9. The system of claim 1,wherein the inwardly-facing scallop includes a plurality of scallops andthe outwardly-extending tab of the first liner includes a plurality oftabs sized and shaped to be received in the plurality of scallops. 10.The system of claim 1, wherein, the inner surface of the shell has apolished finish, and the tapered outer wall of the second liner has aroughened finish.
 11. The system of claim 10, wherein a surfaceroughness of the inner surface is less than 16 microinches.
 12. Anacetabular cup system, comprising: a shell having a generally concaveinner surface, an outer surface, an end face formed at an uppermost endof the shell, an apex formed at a lower end of the shell, and a centralaxis extending through the apex, wherein the inner surface comprises aninwardly-facing scallop defined in the inner surface and extending intothe end face, at least a portion of the inner surface defining a taperwith respect to the central axis, the tapered portion of the innersurface extending below the scallop, a protrusion located below thetapered portion of the inner surface, a lower groove located below theprotrusion, and an upper groove formed in a portion of the wallextending below the tapered portion; a first liner comprising generallyconvex first outer portion, the first outer portion including anoutwardly-extending tab, an upper bump, and a lower bump, wherein thefirst liner is formed of a polymer material; and a second linercomprising a generally convex second outer portion, the second outerportion including a tapered outer wall, wherein the second liner isformed of a metallic material; wherein the shell is configured toreceive each of the first liner and the second liner; wherein when thefirst liner is seated in the shell, the tab is received in the scallop,the upper bump is received in the upper groove, the lower bump isreceived in the lower groove and engaged with a lower side of theprotrusion, and an interference fit is formed between the first linerand the shell, the interference fit including at least engagement of theupper bump with the upper groove and the lower bump with the lowergroove; and wherein when the second liner is seated in the shell, thetapered outer wall is engaged with the tapered portion of the innersurface upper wall of the shell, and the second liner is retained in theshell by engagement between the tapered portion of the inner surface andthe upper wall.
 13. The system of claim 12, further comprising a thirdliner including a generally convex third outer portion, the third outerportion including a second tapered outer wall; wherein the third lineris formed of a ceramic material; and wherein when the third liner isseated in the shell, the tapered portion of the inner surface is engagedwith the second tapered outer wall, and the third liner is retained inthe shell by engagement of the tapered portion of the inner surface withthe second tapered outer wall.
 14. The system of claim 12, wherein adistance between the upper groove and the lower groove is between twomillimeters and four millimeters.
 15. The system of claim 12, whereinthe protrusion is positioned between the lower and upper grooves. 16.The system of claim 12, wherein the inwardly-facing scallop includes aplurality of scallops and the outwardly-extending tab of the first linerincludes a plurality of tabs sized and shaped to be received in theplurality of scallops.